Provider Demographics
NPI:1851385728
Name:GUINN, CHRISTOPHER PETE (C PED)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PETE
Last Name:GUINN
Suffix:
Gender:M
Credentials:C PED
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Mailing Address - Street 1:2102 BLALOCK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2428
Mailing Address - Country:US
Mailing Address - Phone:512-490-1255
Mailing Address - Fax:512-490-1297
Practice Address - Street 1:2102 BLALOCK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2428
Practice Address - Country:US
Practice Address - Phone:512-490-1255
Practice Address - Fax:512-490-1297
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2010-10-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171115202Medicaid
TX171115204Medicaid
TX171115202Medicaid